FDA Adverse Event Malfunction Summary report: N

PRISMAFLEX SETS (OXIRIS)

MDR report key: 22507742 · Received July 15, 2025

Report

Report Number
8010182-2025-00393
Event Type
Malfunction
Date Received
July 15, 2025
Date of Event
June 21, 2025
Report Date
August 13, 2025
Manufacturer
VANTIVE US HEALTHCARE LLC
Product Code
KDI
UDI-DI
07332414124090
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: H6, H11. H11: THE ACTUAL DEVICE WAS NOT AVAILABLE; HOWEVER, PHOTOGRAPHS OF THE SAMPLE WERE PROVIDED FOR EVALUATION. VISUAL INSPECTION OF THE PHOTOS SHOWED A LEAK FROM THE SET ACCESS PRE-PUMP POD. THIS COMPONENT IS MANUFACTURED BY A VANTIVE EXTERNAL SUPPLIER. A BATCH REVIEW WAS CONDUCTED AND THERE WERE NO DEVIATIONS FOUND RELATED TO THIS REPORTED CONDITION DURING THE MANUFACTURE OF THIS LOT. THE REPORTED CONDITION WAS VERIFIED. THE CAUSE OF THE POD DEFECT WAS DETERMINED TO BE RELATED TO SUPPLIER MANUFACTURING. TWO (2) NONCONFORMANCE RECORDS HAVE BEEN OPENED TO INVESTIGATE AND ADDRESS THIS ISSUE. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

OXIRIS C IS SIMILAR TO OXIRIS AND OXIRIS S. OXIRIS AND OXIRIS S HAVE BEEN TEMPORARILY APPROVED FOR USE IN THE US UNDER EMERGENCY USE AUTHORIZATION EUA: (B)(4) WITH A SPECIFIC INDICATION TO TREAT PATIENTS WITH COVID-19 INFECTION. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT AFTER 10 HOURS OF CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) USING A PRISMAFLEX OXIRIS FILTER SET, THE PRESSURE SENSOR MEMBRANE WAS FOUND DAMAGED AND LEAKING BLOOD. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
159858 PRISMAFLEX SETS (OXIRIS) DIALYZER, HIGH PERMEABILITY WITH OR WITHOUT SEALED DIALYSATE SYSTEM KDI VANTIVE US HEALTHCARE LLC NA 24F0086 07332414124090

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown